Electrode equipped electro-dermal device

Abstract

An electro-dermal connector device includes a flexible non-conductive sheet and electrode sensors V₁ to V₆ disposed on the non-conductive sheet in a dimensional array and adapted for electrical connection with the skin for receiving and transmitting electrical impulses. On the non-conductive sheet the distance between electrodes V₁ and V₂ is 2.00 inches ±0.56 inches, and the distance between V₂ and V₄ is about 3.5 inches ±1.00 inch, with V₃ located substantially midway between V₂ and V₄ and V₅ is generally equidistant between V₄ and V₆.

Description

RELATED U.S. APPLICATION

This application is a continuation of application Ser. No. 08/783,721, now U.S. Pat. No. 5,916,159, filed Jan. 16, 1997, which is a continuation-in-part of U.S. application Ser. No. 08/508,928, filed Jul. 28, 1995, now abandoned.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to a medical device for use when employing electrical signals to monitor or stimulate various parts of the body. More particularly, the present invention involves a connector device for establishing electrical connection to a patient's skin by use of an array of electrodes.

2. Description of the Prior Art

Prior art medical electrodes generally are combination structures including a metallic or otherwise conductive support member to which an electric wire from an assorted apparatus may be attached. Generally, electrocardiograms sometimes referred to as an EKG or ECG have ten cable leads which attach to various points on the upper and mid-torso of a patient to measure and analyze cardiac data.

Of primary concern when preparing for an electrocardiogram is accurate placement of the electrodes. The person responsible for attaching the electrodes and lead wires ("leads") of the EKG often has problems in attaching these multiple leads to the patient because the lead wires may tangle with one another or, in the case of suction-type electrodes, may become detached before or after they are all connected. Accurately placing and securing a large number of leads can be difficult and time consuming and requires the knowledge of a skilled technician or physician.

Periodic electrocardiograms can provide a cardiographic profile of a patient for early detection and diagnosis of cardiovascular diseases. For purposes of providing an accurate profile, it is important not only that the electrocardiogram be taken with sensors (i.e., electrodes) affixed accurately, but that the sensors are placed at the same location on the patient as for the previous electrocardiograms. The accuracy of the reproducible results is critical so that a series of electrocardiograms can be compared, between testing episodes, to provide a continuing profile of a patient for diagnosis and treatment of heart disease.

A full screen, ten electrode (twelve lead) electrocardiograph provides the most accurate picture for recognizing ischemic electrocardiographic changes. However, in urgent situations, including those electrocardiograms taken during an acute symptomatic episode of a cardiac patient, only two to four electrodes may be attached to the patient. Therefore, it would be advantageous and desirable to have a device which enables more leads to be accurately placed and quickly secured during an acute symptomatic episode.

On the other hand it may be necessary to quickly remove certain or all of the chest leads of the EKG when a patient is experiencing another heart attack in order to administer CPR, to massage the heart, administer drugs or apply electrical defibrillation paddles. Accordingly, valuable seconds are often lost in removing the chest leads of the EKG device in order to administer aid to the patient.

U.S. Pat. No. 4,328,814 to Arkans teaches a plurality of electrodes arranged in a strip. Each electrode has a conductive lead which runs to a single junction connector having one cable leading to the EKG device. This device is designed for an adult patient so that patients having larger or smaller torsos will have difficulty in using the device because the electrodes cannot be easily adjusted to accommodate a smaller or larger torso.

U.S. Pat. No. 4,353,372 to Ager discloses a plurality of electrodes which plug into a junction box connected to an EKG machine. Each of the electrodes includes wires molded into a central cable system which joins the junction box. This device does not include means for quickly attaching or removing the electrodes. For example, in an emergency situation if the electrodes must be removed quickly, the junction box must be disconnected first and then each of the electrodes must be detached. Although each electrode has a wire lead from the main molded cable, which may permit some adjustment in the placement of the electrodes on the upper portion of a human torso, the device is not entirely adequate for large adults or very small children because of the limited adjustment of each electrode.

U.S. Pat. No. 3,910,260 describes telephonic units for transmitting EKG signals to ECG receiving equipment which could be at a hospital or a physician's office. The transmission may take place in emergency vehicles where prior medical history may not be readily available. In order to obtain meaningful and reliable data ECG signals are necessary for the care providers.

U.S. Pat. No. 4,608,987 to Mills relates to a vest-like garment having a plurality of apertures adapted for receiving associated electrodes. However, the vest is not tailored for a specific patient and proper fit is provided by adjustable straps which may be secured by VELCRO material. Therefore, there is no assurance that the electrodes are placed at the same anatomical location upon reuse with the same patient.

U.S. Pat. No. 4,583,549 to Manoli relates to an ECG electrode pad having a flexible non-conductive pad provided with a plurality of electrodes. In this patent, the electrodes are positioned at various anatomically defined positions on the chest wall. Although different size pads are contemplated, this patent lacks any teaching or suggestion of how the sizes are dimensioned, how they would be determined, or even how a patient would be fitted with the proper size.

U.S. Pat. No. 5,184,620 to Cudahy discloses a multiple electrode pad for monitoring a patient's cardiac electrical activity. A flexible pad is equipped with a plurality of groups of electrodes. In one embodiment each group has two electrodes, and in another embodiment three electrodes form each group.

U.S. Pat. No. 5,224,479 to Sekine illustrates a vest-like ECG diagnostic pad provided with upper limb lead electrodes, precordial lead electrodes and flank lead electrodes. The precordial lead electrodes are positioned on the pad to come into contact with anatomically prescribed locations on the midriff portion of the patient.

None of the prior art devices disclose a low cost solution for obtaining repeatable placement of sensors for accurate and readable ECG signals in the field by unskilled individuals.

Because of the inadequacies of prior art devices there is a need for a system which prevents EKG electrode leads from being entangled; provides quick removal of some of the electrodes while leaving the remaining electrodes in position when it is necessary to administer aid to a patient having a heart attack; provides accurate repeatable placement of electrodes at substantially the same anatomical location; accurately and repeatedly obtains signals from body electrodes by efficient and effective electrical transmission; may be attached by unskilled persons; and may be available in various sizes to accommodate different size patients.

SUMMARY OF THE INVENTION

The present invention, in one aspect involves a non-conducting flexible sheet incorporating an array of sensory electrodes. The electrodes are positioned on the flexible sheet in a manner that allows for only a few different sizes of sheets to be capable of fitting the vast majority of adult patients.

In another aspect, the invention relates to an electro-dermal connector device comprising a flexible non-conductive sheet comprising a fixed array of electrical conductor strips affixed thereon and positioned in a specific size configuration normally used for standard electrocardiographic recording. The conductor strips having an electrode-like receptor pad end adapted for electrical connection with the skin for receiving impulses and a terminal connection end which is adapted for connection with an electrocardiological measuring apparatus, wherein receptor pads V₁ and V₂ are attached approximately on either side of the sternum at the fourth intercostal space and receptor pad V₃ is positioned midway between V₂ and V₄. V₅ is equidistant between V₄ and V₆. The distance between V₁ and V₂ is about 2.00 inches ±0.56 inches, i.e., V₁ is 1.00 inch ±0.28 inches to the right and V₂ is 1.00 inch ±0.28 inches to the left, measured equidistantly from the centerline of the sternum. The distance between V₂ and V₄ is about 3.5 inches ±1.00 inch, and V₃ is located substantially midway between V₂ and V₄.

Each strip includes at its first end portion or receptor end an electrode for electrical connection with the skin for receiving electrical impulses. A second end portion terminates in a common electrical connection or cable junction which is adapted for connection with a standard type of cable junction for connection with the electrocardiograph device.

The conductive strips may be printed on the single layer non-conductive film or sheet by any conventional printing or skill screening type of process. The portion of the strip which need not be exposed can be coated or covered with a non-conductive (dielectric) coating. Conducting strips which are less than 20 micrometers in thickness provide enhanced flexibility without distorting the electrical signal.

In another aspect of the invention, the flexible non-conductive sheet is provided in a plurality of sizes, with each size having electrodes V₁, V₂, V₃ and V₄ at substantially the same locations and having electrodes V₅ and V₆ at different locations depending on size. In this regard, the locations of the receptor ends V₅ and V₆ are based on a measured distance between a midclavicular line and a midaxillary line on the chest of the patient.

In yet another aspect of the invention, a method is disclosed for sizing a patient for fitting an electrodermal connector device comprising a flexible non-conductive sheet, electrode sensors V₁ -V₆ disposed on the flexible non-conductive sheet and adapted for electrical connection with the skin for receiving and transmitting electrical impulses, with the distance between V₁ and V₂ being 2.00 inches ±0.56 inches, and the distance between V₂ and V₄ being about 3.5 inches ±1.00 inch, with V₃ located substantially midway between V₂ and V₄ and V₅ being generally equidistant between V₄ and V₆, and means for electrically connecting the electrode sensors to an electrocardiological measuring apparatus. The method comprises the steps of measuring the distance between a midclavicular line and a midaxillary line on the chest of the patient, and selecting a connector device based on the measured distance.

These and other objects, aspects, features and advantages of the present invention will become apparent from the following detailed description of the preferred embodiments taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a preferred device of the present invention provided with electrode end sensors for attachment to the torso of a patient.

FIG. 2 shows a portion of the device illustrated in FIG. 1 as it is properly positioned on a patient.

FIG. 3 illustrates the first step in the method for determining the size of the device to be used on a patient according to this invention.

FIG. 4 shows another step in the method for determining the size of the device to be placed on a patient according to this invention.

FIG. 5 illustrates the positioning of the dimensional array according to this invention.

FIG. 6 shows preferred dimensions of receptors V₂, V₃ and V₄ in the dimensional array.

FIGS. 7A-7C show a dimensional layout of a small, medium and large device according to this invention.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring now to the drawings, FIGS. 1 and 5 illustrate an electro-dermal connector device 10 in accordance with a first embodiment of the invention. In this embodiment, an array of electrode receptors 22 are positioned at a predetermined dimensional array V₁ -V₆ on the device 10.

FIG. 1 illustrates the connector device of the present invention for placement on the chest of a patient. The connector device is formed of a flexible non-conducting sheet 11 incorporating multiple conductor strips 12 for connection to a standard electrocardiographic receiving unit. The conductor strips 12 have at their first end portion electrode sensors or receptors 22 which are positioned on the sheet and spaced relative to each other. The electrode sensors 22, per se, are conventional electrodes, and are positioned in a specific size configuration in accordance with the subject invention appropriate for electrocardial recordings.

Each strip 12 includes at its second end a terminal conductor end 23 to engage a common electrical connection or cable junction (not shown) for connection with the electrocardiograph device (not shown).

When in use, an electrically conductive ink containing a biocompatable adhesive gel is applied to the body contacting side of sheet 11 at each receptor 22 of strip 12 for adhesion to the skin of the patient for providing electrical connection between each of the precordial ends and the terminal end 23 connected to the proper receiving devices (not shown).

The adhesive gel coated area of the connector device includes at least one release liner in releasable adhesive contact with the gel. Each of the conductor strips 12 are less than 10, and preferably less than 5, micrometers in thickness whereby the flexibility of the connector and adhesion of the gel surface to the skin are substantially enhanced.

FIG. 1 shows the connector array (V₁, V₂, V₃, V₄, V₅ and V6) on the flexible sheet 11 which is designed to adhere to a human torso so that the electrode sensors 22 are located below the sternum, over the epigastric region of the abdomen and near the centerline of the torso. The flexible sheet 11 can be substantially transparent and includes an opening in the proximate center which is intended to span the upper portion of the sternum of the patient. The sheet may include indicia adjacent to or on each of the conductor strips to facilitate correct placement of the receptors on the precordial areas of the human torso.

FIG. 2 illustrates the position of the electro-dermal connector device 10 as it is properly positioned upon a patient. The connector device 10 is generally attached by adhering the precordial receptors. The receptors V₁ and V₂ are attached approximately on opposite sides of the sternum at the fourth intercostal space. Receptor pads V₃ and V₄ are attached over the ribs, with pad V₃ positioned approximately equidistant between V₂ and V₄. Pads V₅ and V₆ are placed at the side of the torso so that V₅ is substantially midway between V₄ and V₆. For small sizes the distance between V₄ and V₆ is on the average of 3.5 inches, for medium sizes 5.0 inches and for large sizes 7 inches. Of course, these measurements have a degree of tolerance, e.g., ±1.0 inch, to provide a range within which the connector device operates effectively. It should also be appreciated that distances between any of the receptor pads that fall outside the ranges disclosed herein are still considered to be within the scope of the invention as long as an effective, easy to use connector device is provided in consonance with the disclosed invention. The contour of the template 10 is configured to conform substantially to the shape of a human trunk.

In cross section a preferred laminate of the invention comprises the following layers:

a) a flexible non-conductive film of polyethylene terphthalate;

b) a catalyst layer in contact with silver ink;

c) a connector strip comprised of silver ink;

d) a dielectric layer in contact with silver ink;

e) a conductive hydrogel layer superimposed upon the silver ink layer; and

f) a flexible release liner as the top layer superimposed upon the conductive hydrogel.

The flexible non-conductive web or sheet 11 may be formed from any non-conductive flexible natural or synthetic sheet material which is capable of accepting a print. Generally any cellulosic material, polyester, polyolefin, polyvinyl chloride, nylon or mixtures thereof would be suitable. Cotton, polypropylene, polyethylene can be used because of cost. However, polyester is most preferred. The polymer sheet material may be color coded for specific body areas or may contain an outline and/or color markings to simplify attaching or positioning of the electro-dermal connector device. As mentioned earlier the device of this invention is designed to include the use by an untrained or trained individual. This device allows an untrained person including the patients themselves to obtain highly reliable and repeatable ECG signals.

The electrodes 22 can be made of any electrically conductive material, e.g., metals, conductive polymers, graphite, carbon fibers and the like. Conductive materials such as gold, copper, silver, tin, aluminum, N-vinyl pyrrolidone and alloys or mixtures thereof may be used. The electrode can also be made of metal foil or could be adhered by a printing or silk-screening process. It will be appreciated that formation of the electrodes on the sheet 11 will create a charge differential between each electrode and its respective conductor strip 12.

Copper strips may be electrolessly deposited on the polymeric sheets in a range of thickness from about 0.25 to about 5 microns, more preferably from 0.25 to 1.5 microns and most preferably 0.4 microns in thickness.

If desired, the exposed conductive strips may be partially coated with a dielectric polymeric material so that only selective portions are exposed. Suitable dielectric coatings include polyesters, ethylene-vinyl acetate copolymers, polyvinyl chloride and its copolymers, terpolymers such as acrylonitrile-butadiene styrene (ABS resins) and inter alia.

Preferable to copper, however, a metallic ink may be used, such as a silver ink commercially available and marketed by Dupont Chemical Corp. of Wilmington, Del. under the tradename Composition 9793.

One conductive adhesive hydrogel used is manufactured by Polyflex Circuits. Other suitable conductive adhesives are sold commercially by Lec Tec Corporation of Eden Prairie, Minn. and by 3M Corporation of St. Paul, Minn. Although an adhesive hydrogel is preferred any commercial electro-dermal adhesive would be operable. Preferably the area size of the hydrogel is between about 3 and 9 square centimeters.

The flexible release liner may be made from a suitable dielectric film or coated paper which includes polyesters, olefinic polymers, polyvinyl chloride and its copolymers, acrylic rubbers, ABS resin and the like.

In a preferred embodiment the electro-dermal connector 10 comprises at least six gel contact areas and is adapted for use in electrocardiography.

In accordance with the subject invention, the electro-dermal connector device 10 is available in various sizes. More specifically, by properly positioning the dimensional array V₁ -V₆, a connector device having three sizes (small, medium and large) is sufficient to accommodate nearly any size adult person. In positioning the array, it has been found that the distance between pads V₁ to V₄ is generally consistent for all sizes. The dimensions between V₁, V₂, V₃ and V₄ have been developed to accommodate nearly all adults within tolerances acceptable for the resting ECG. It has also been found that body placement for pads V₅ and V₆ vary depending on individual size. Although in this embodiment three sizes are disclosed, it will be appreciated that connector devices of different sizes are well within the scope of the invention.

FIG. 3 shows a method of determining the proper size. In this figure, the measurement M from the V₄ position to V₆ position determines the size of the device. This measurement can be determined by having the technician measure, such as by using his/her thumb and the middle finger, the distance between the midclavicular line and midaxillary line on the chest of the patient. This distance is then matched to a scale provided as shown in FIG. 4. The table below corresponds to the illustrated scale.

TABLE I
SIZE                      V4 -V5  V5 -V6
Small                     1.75" 1.75"
Medium                    2.50" 2.50"
Large                     3.50" 3.50"

Generally, the size of the vest is determined by the distance between V₄ to V₆. That is, the distance between the midclavicular line and the midaxillary line on the patient. For a small vest the distance between V₄ and V₆ can range from about 2.5 to 4.5 inches, for the medium vest the distance can range from about 4.0 to 6.0 inches, and for the large vest the distance can range from about 6.0 to 8.0 inches.

In all sizes of the device of the invention, V₁, V₂, V₃ and V₄ are generally positioned the same. With reference to FIG. 5, the center of V₁ is located on a point generally about 2.00 inches ±0.56 inches from the center of V₂ approximately on the 270 (90) degree radial from the center of V₂ wherein the radial is measured with zero degrees from the top of V₂. The center of V₄ is located on a point generally 3.5 inches ±1.00 inch from the center of V₂ approximately on the 125 (235) degree radial from the center of V₂. The center of V₃ is in line with V₂ and V₄ and is located on a point substantially between the center of V₂ and the center of V₄. FIG. 6 shows preferred dimensions for V₂, V₃ and V₄.

A typical dimensional layout for V₅ and V₆ relative to V₄ is shown in FIGS. 7A, 7B and 7C, and is as follows:

TABLE II
SIZE                      V4 -V5  V5 -V6
Small                     1.75" 1.75"
Medium                    2.50" 2.50"
Large                     3.50" 3.50"

The distance between V₁ and V₂ is 2.00 inches, the distance between sternum centerline and V₄ along a horizontal line is 3.85 inches and the distance between V₂ and V₄ along a vertical line is 2.00 inches, although this vertical distance could be up to 3.50 inches without considerably altering the effectiveness of the device. In addition, V₃ is located on a diagonal line between V₂ and V₄ and is equidistant from V₂ and V₄.

As discussed above, the connector device can be sized to accommodate practically any size adult person. Even if the person is smaller than the "small" size device, a connector device of the small (or even medium or large) size can be used by folding the flexible sheet 11 over on itself to reduce the distances between the connector arrays as appropriate.

It will be appreciated that although the embodiment disclosed above shows the flexible non-conductive sheet 11 in use with printed electrodes, other types of conventional electrodes, e.g., tab electrodes or snap electrodes, can be used without departing from the scope of the invention. Likewise, alternatives to the printed conductor strips 12, e.g., lead wires, can of course be used to transmit signals between the electrodes and the electrocardiological measuring apparatus.

Although a specific embodiment of the present invention have been described above in detail, it will be understood that this description is merely for purposes of illustration. Various modifications of and equivalent structures corresponding to the disclosed aspects of the preferred embodiments in addition to those described above may be made by those skilled in the art without departing from the spirit of the present invention which is defined in the following claims, the scope of which is to be accorded the broadest interpretation so as to encompass such modifications and equivalent structures.

Claims

1. An electro-dermal device comprising:

a non-conductive substrate;

electrode sensors V₁ -V₆ disposed on said non-conductive substrate in a dimensional array and adapted for electrical connection with the skin for receiving and transmitting electrical impulses, with said electrode sensors V₁, V₂, V₃ and V₄ positioned at predetermined fixed locations on said substrate and said electrode sensors V₅ and V₆ positioned at predetermined fixed locations on said substrate which vary dependent on patient size, wherein

the distance between V₁ and V₂ is approximately 1.50 to 2.50 inches, and the distance between V₂ and V₄ is approximately 2.50 to 4.50 inches, with V₃ located substantially midway between V₂ and V₄, and V₅ being generally equidistant between V₄ and V₆ ; and

a transmitter to transmit the electrical impulses from said electrode sensors to an electrocardiological measuring apparatus.

2. The device of claim 1, wherein said substrate is selected from non-conductive flexible natural or synthetic sheet material.

3. The device of claim 2, wherein said substrate is selected from cellulosic materials, polyesters, polyolefins, polyvinyl chloride or nylon.

4. The device of claim 3, wherein said cellulosic material is cotton or paper.

5. The device of claim 3, wherein said polyester is polyethylene terphthalate.

6. The device of claim 1, wherein said transmitter includes a fixed array of electrical conductor strips disposed on said non-conductive substrate.

7. The device of claim 6, wherein said conductor strips are selected from metal, polymer, graphite or carbon fibers.

8. The device of claim 7, wherein said metal is selected from gold, copper, silver, tin or aluminum and alloys or mixtures thereof.

9. The device of claim 8, wherein said conductor strips are made of metal foil or a metal paste.

10. The device of claim 9, wherein said metal paste is printed or silk screened onto said non-conductive substrate.

11. The device of claim 8, wherein said metal paste is electrolessly deposited on said non-conductive substrate.

12. The device of claim 8, wherein said conductor strips are preferably 0.08 to 0.10 microns in thickness.

13. The device of claim 7, wherein said conductive strips are coated with a dielectric polymeric material so that only sensitive portions are exposed.

14. The device of claim 13, wherein said polymeric material is selected from the group consisting of polyesters, copolymers of ethylene-vinyl acetate, homopolymers and copolymers of polyvinylchloride and ABS resin.

15. The device of claim 1, wherein the distance between V₄ and V₅ and between V₅ and V₆ is about 1.75 inches.

16. The device of claim 1, wherein the distance between V₄ and V₅ and between V₅ and V₆ is about 2.5 inches.

17. The device of claim 1, wherein the distance between V₄ and V₅ and between V₅ and V₆ is about 3.5 inches.

18. The device of claim 1, wherein V₁ is located 2.00 inches ±0.56 inches in radius on about the 270 degree radial from the center of V₂.

19. The device of claim 1, wherein electrode sensor V₃ is located approximately midway between V₂ and V₄.

20. The device of claim 19, wherein said electrode sensor V₃ is located on about a 125 degree radial from the center of V₂.

21. The connector device of claim 1, wherein said nonconductive substrate is disposable.

22. The device of claim 1, wherein V₅ and V₆ can be positioned at three different locations on said substrate.

23. A method of fitting a patient with an electrodermal connector device having a non-conductive substrate with electrode sensors V₁ -V₆ disposed on the non-conductive substrate in a dimensional array and adapted for electrical connection with the skin for receiving and transmitting electrical impulses, and a transmitter to transmit the electrical impulses, with said electrode sensors V₁, V₂, V₃ and V₄ positioned at predetermined fixed locations on said substrate and said electrode sensors V₅ and V₆ positioned at predetermined fixed locations on said substrate which vary dependent on patient size, said method comprising the steps of:

measuring the distance between a midclavicular line and a midaxillary line on the chest of the patient;

selecting a connector device with electrode sensors V₅ and V₆ located at their predetermined fixed locations based on the measured distance; and

positioning the selected device on the patient.

24. A method of fitting a patient according to claim 23, further comprising the step of selecting a device with a distance of 1.75" between V₄ and V₅ and 1.75" between V₅ and V₆ when the measured distance is between 2.5" and 4.5".

25. A method of fitting a patient according to claim 23, further comprising the step of selecting a device with a distance of 2.5" between V₄ and V₅ and 2.5" between V₅ and V₆ when the measured distance is between 4.0" and 6.0".

26. A method of fitting a patient according to claim 23, further comprising the step of selecting a device with a distance of 3.5" between V₄ and V₅ and 3.5" between V₅ and V₆ when the measured distance is between 6.0 and 8.0".

27. A method of fitting a patient according to claim 23, wherein the distance between V₁ and V₂ is 1.50 to 2.50 inches, and the distance between V₂ and V₄ is 2.50 to 4.50 inches, with V₃ located substantially midway between V₂ and V₄, and V₅ is equidistant between V₄ and V₆.

28. A process of forming an electro-dermal device for electrocardiographic recording, comprising the steps of:

providing a nonconductive substrate for supporting a fixed array of electrode sensors V₁ -V₆ in a specific size configuration appropriate for electrocardiographic recording;

positioning electrode sensors V₁, V₂, V₃ and V₄ at predetermined fixed locations on the substrate;

positioning electrode sensors V₅ and V₆ at predetermined fixed locations on the substrate which vary dependent on patient size, and

providing a transmitter on the substrate to transmit electrical impulses from the electrode sensors.

29. A process according to claim 28, further comprising the step of positioning the electrode sensors V₁ -V₆ such that the distance between V₁ and V₂ is approximately 1.50 to 2.50 inches, and the distance between V₂ and V₄ is approximately 2.50 to 4.50 inches, with V₃ located substantially midway between V₂ and V₄, and V₅ is generally equidistant between V₄ and V₆.

30. A process according to claim 29, further comprising the step of positioning the electrode sensors V₅ and V₆ based on a measured distance between a midclavicular line and a midaxillary line on the chest of the patient.

31. A process according to claim 29, further comprising the step of positioning electrode sensors V₁ and V₂ to be approximately on either side of the sternum at the fourth intercostal space and positioning electrode sensor V₃ to be approximately midway between V₂ and V₄.

32. A process according to claim 28, wherein the distance between V₄ and V₅ and between V₅ and V₆ for a small size is about 1.75 inches, for a medium size is about 2.5 inches, and for a large size is about 3.5 inches.

33. A process according to claim 28, wherein V₁ is located 2.00 inches ±0.56 inches in radius on about a 270 degree radial from the center of V₂.

34. A process according to claim 28, wherein V₃ is located on about a 125 degree radial from the center of V₂.

35. A process according to claim 28, further comprising the step of providing a disposable nonconductive substrate.

36. A process according to claim 28, wherein sensors V₅ and V₆ can be positioned at three different locations on the substrate.

37. A plurality of electro-dermal devices of different sizes, with each device comprising:

a nonconductive substrate;

electrode sensors V₁ -V₆ disposed on said nonconductive substrate in a dimensional array and adapted for electrical connection with the skin for receiving and transmitting electrical impulses, with said electrode sensors V₁, V₂, V₃ and V₄ positioned at predetermined fixed locations on each said substrate and electrode sensors V₅ and V₆ positioned at predetermined fixed locations on each said substrate size which vary dependent upon the size of the patient; and

a transmitter to transmit the electrical impulses from said electrode sensors to an electrocardiological measuring apparatus, wherein

on each device the distance between V₁ and V₂ is approximately 1.50 to 2.50 inches, and the distance between V₂ and V₄ is approximately 2.50 to 4.50 inches, with V₃ located substantially midway between V₂ and V₄, and V₅ is generally equidistant between V₄ and V₆.

38. A plurality of electro-dermal connector devices as set forth in claim 37, wherein said nonconductive substrates are disposable.

39. A process of forming a plurality of electro-dermal devices of different sizes, comprising the steps of:

providing a plurality of nonconductive substrates;

affixing electrode sensors V₁ -V₆ on each substrate in a specific size configuration appropriate for electrocardiographic recording, with the electrode sensors adapted for electrical connection with the skin for receiving and transmitting electrical impulses and having a terminal connection end which is adapted for connection with an electrocardiological measuring apparatus;

positioning electrode sensors V₁, V₂, V₃ and V₄ substantially at the same locations on each size substrate; and

positioning electrode sensors V₅ and V₆ differently on each size substrate dependent upon the size of the patient.

40. A process according to claim 39, further comprising the step of positioning electrode sensors V₁ to V₆ on each size substrate such that a distance between V₁ and V₂ is approximately 1.50 to 2.50 inches and the distance between V₂ and V₄ is approximately 2.50 to 4.50 inches, with V₃ located substantially midway between V₂ and V₄, and V₅ is substantially equidistant between V₄ and V₆.

41. A process according to claim 39, wherein the electrode sensors V₅ and V₆ are positioned at fixed locations based on a measured distance between a midclavicular line and a midaxillary line on the chest of the patient, with the fixed location varying for each size substrate.

42. A process according to claim 39, further comprising the step of, on each size substrate, positioning electrode sensors V₁ and V₂ to be approximately on either side of the sternum at the fourth intercostal space and positioning V₃ to be approximately midway between V₂ and V₄.

43. A process according to claim 39, wherein three electro-dermal devices are formed, with the distance between V₄ and V₅ and between V₅ and V₆ for a small size device being about 1.75 inches, for a medium size device being about 2.50 inches, and for a large size device being about 3.50 inches.

44. A process according to claim 39, wherein V₁ on each size substrate is located about 2.00 inches ±0.56 inches in radius on about a 270 degree radial from the center of V₂.

45. A process according to claim 39, wherein V₃ and V₄ on each size substrate are located on about 125 degree radial from the center of V₂.

46. A process according to claim 39, wherein the nonconductive substrates are disposable.